Abstract
AIMS: An increased mortality risk during weekend hospital admission has been consistently observed. In the present study, we evaluated whether the current improvement in management of acute coronary syndromes (ACS) has reduced this phenomenon. METHODS AND RESULTS: We extracted data from the Italian National Healthcare System Databank of 80 391 ACS admissions in the region of Lombardia between 2010 and 2014. ICD-9 codes were used to assess the diagnosis. We performed a multiple logistic regression analysis to compare the mortality rates between weekend and weekday admissions.Mean age of the study population was 67.6 years; 30.1% of patients were women. ST segment elevation myocardial infarction (STEMI) accounts for 42.2% of admissions. The total in-hospital mortality was 3.05% and was positively predicted by weekend admission [odds ratio (OR) 1.13, P = 0.006], age and female sex. The weekend effect on mortality was only significant for STEMI (OR 1.11, P = 0.04) in comparison to non-STEMI (NSTEMI) or unstable angina.The trend of the risk of death was found to be negatively correlated with age: the risk of death was significantly higher in all age clusters younger than 75 (OR 1.22, P < 0.01) and even greater in the very young subgroup under 45 years of age (OR 2.09, P = 0.03). CONCLUSION: Our data indicate that increased mortality risk is still present during weekend admissions. This phenomenon is particularly evident in younger patients and in individuals admitted for STEMI.
| Original language | English |
|---|---|
| Pages (from-to) | 74-80 |
| Number of pages | 7 |
| Journal | Journal of cardiovascular medicine (Hagerstown, Md.) |
| Volume | 20 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 1 2019 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Higher in-hospital mortality during weekend admission for acute coronary syndrome : a large-scale cross-sectional Italian study. / Malanchini, Giovanni; Stefanini, Giulio Giuseppe; Malanchini, Margherita; Lombardi, Federico.
In: Journal of cardiovascular medicine (Hagerstown, Md.), Vol. 20, No. 2, 01.02.2019, p. 74-80.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Higher in-hospital mortality during weekend admission for acute coronary syndrome
T2 - a large-scale cross-sectional Italian study
AU - Malanchini, Giovanni
AU - Stefanini, Giulio Giuseppe
AU - Malanchini, Margherita
AU - Lombardi, Federico
PY - 2019/2/1
Y1 - 2019/2/1
N2 - AIMS: An increased mortality risk during weekend hospital admission has been consistently observed. In the present study, we evaluated whether the current improvement in management of acute coronary syndromes (ACS) has reduced this phenomenon. METHODS AND RESULTS: We extracted data from the Italian National Healthcare System Databank of 80 391 ACS admissions in the region of Lombardia between 2010 and 2014. ICD-9 codes were used to assess the diagnosis. We performed a multiple logistic regression analysis to compare the mortality rates between weekend and weekday admissions.Mean age of the study population was 67.6 years; 30.1% of patients were women. ST segment elevation myocardial infarction (STEMI) accounts for 42.2% of admissions. The total in-hospital mortality was 3.05% and was positively predicted by weekend admission [odds ratio (OR) 1.13, P = 0.006], age and female sex. The weekend effect on mortality was only significant for STEMI (OR 1.11, P = 0.04) in comparison to non-STEMI (NSTEMI) or unstable angina.The trend of the risk of death was found to be negatively correlated with age: the risk of death was significantly higher in all age clusters younger than 75 (OR 1.22, P < 0.01) and even greater in the very young subgroup under 45 years of age (OR 2.09, P = 0.03). CONCLUSION: Our data indicate that increased mortality risk is still present during weekend admissions. This phenomenon is particularly evident in younger patients and in individuals admitted for STEMI.
AB - AIMS: An increased mortality risk during weekend hospital admission has been consistently observed. In the present study, we evaluated whether the current improvement in management of acute coronary syndromes (ACS) has reduced this phenomenon. METHODS AND RESULTS: We extracted data from the Italian National Healthcare System Databank of 80 391 ACS admissions in the region of Lombardia between 2010 and 2014. ICD-9 codes were used to assess the diagnosis. We performed a multiple logistic regression analysis to compare the mortality rates between weekend and weekday admissions.Mean age of the study population was 67.6 years; 30.1% of patients were women. ST segment elevation myocardial infarction (STEMI) accounts for 42.2% of admissions. The total in-hospital mortality was 3.05% and was positively predicted by weekend admission [odds ratio (OR) 1.13, P = 0.006], age and female sex. The weekend effect on mortality was only significant for STEMI (OR 1.11, P = 0.04) in comparison to non-STEMI (NSTEMI) or unstable angina.The trend of the risk of death was found to be negatively correlated with age: the risk of death was significantly higher in all age clusters younger than 75 (OR 1.22, P < 0.01) and even greater in the very young subgroup under 45 years of age (OR 2.09, P = 0.03). CONCLUSION: Our data indicate that increased mortality risk is still present during weekend admissions. This phenomenon is particularly evident in younger patients and in individuals admitted for STEMI.
UR - http://www.scopus.com/inward/record.url?scp=85058894256&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058894256&partnerID=8YFLogxK
U2 - 10.2459/JCM.0000000000000743
DO - 10.2459/JCM.0000000000000743
M3 - Article
C2 - 30540646
AN - SCOPUS:85058894256
VL - 20
SP - 74
EP - 80
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 2
ER -